Patent foramen ovale (pfo) closure service evaluation: remote mdt, local anaesthesia and intracardiac echo (ice) during the covid-19 pandemic

ABSTRACT

60 Table 1Basic characteristics and vascular risk factors in two groupsCharacteristics Closure group (n=38) MM group (n=40) P value Median age 45 54 0.001 Age range 21-65 23-79 Highest age group 30-39 (n=12) & 50-59 (n=12) 50-59 (n=14) Males 23 (61%) 25 (62%) 0.43 Females 15 (39%) 15 (38%) Diabetes 2 (5%) 8 (20%) 0.02 Hypertension 6 (15%) 18 (45%) 0.002 Current smokers 6 (15%) 5 (12.5%) 0.41 Ex-smokers 4 (11%) 4 (10%) 0.46 Hyperlipidaemia 13 (34%) 23 (57%) 0.018 60 Figure 1PFO MDTs outcome closure group 48% (n=38), Medical Management group 51% (n=40) and one patients is waiting to be reviewed to decide about the closure[Figure omitted. See PDF] 60 Figure 2RoPE score is used to identify the patients whose PFOs are likely to be pathogenic rather than incidental. The score involves multiple variables based on vascular risk factors such as diabetes, hypertension, prior history of stroke or TIA and smoking history as well as patientsage and stroke features (cortical and non cortical infarcts)[Figure omitted. See PDF]ConclusionPFO closures at NUH were deemed to be safe day case procedures with no pressure placed on either the TOE or GA services by performing cases under LA and using ICE during the COVID-19 pandemic. A robust and evidence-based practice was followed to choose the suitable patients for the procedure in structured MDT meetings ensuring equitable access for all surrounding hospitals.Conflict of InterestNone